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04-20-09 | Posted by




True confessions time; I have been intimate with a Fraxel®, four times to be exact. My first experience was with the original Fraxel®, when they were still using that blue dye that left you looking like a red faced Smurf for a day. For a woman who has gone through induced labor and a facelift, and for whom lasering under my arms doesn’t cause a whimper, that was bloody painful. A good time was not had by all. My eyes swelled up and I was the color of a boiled lobster for nearly a week, downing steroids and applying ice packs. I had to go to a Dermatology conference shortly after, and Dr. Tina Alster, the laser Diva of DC, gave a shout out to my red blotches during her lecture, noting that “Most people do not get as red as my friend Wendy over there,” as she waved her well manicured hand in my direction.

Dr. Bryan Forley, a mild mannered and unusually attentive Upper East Side plastic surgeon, was the brave one who dared to Fraxel® my face. He deemed me to be a “sweller,” which I admittedly am when it comes to most things. Determined to have another go at me, the good doctor planned to take extra precautions in the future. One of the advantages of this technology is that it is totally customizable – your doctor is in the driver’s seat. The next few times were progressively more manageable with less of the red, no white knuckles (mine or his), and happily minus the blue. Actually the reason I got Fraxeled in the first place was to get rid of the brown – as in annoying freckles (aka age spots), or as my grandmother called them, liver spots. In the end, the brown was almost gone, but not forgotten, and my complexion is decidedly more bouncy like a just picked plum.

Fractionated lasers work in kind of a checkerboard pattern, targeting microscopic squares of damaged skin to reach about 30% of your skin in one session. Since it doesn’t treat all the skin in each area, you need to go back a few times to cover the whole territory. On average three to five sessions is the usual course per area; that is, face or neck or chest or hands (both of them). The end result is undoubtedly smoother texture, tighter pores, fewer or lighter speckles, springier skin that looks and feels younger. The discomfort is entirely do-able when you are topically numbed and you have a friendly doctor who uses blasts of Arctic air to frost your skin before the laser touches you. Dr. Forley did all of the above, and offered up a session under an LED, a low level light, to help get the red out faster. If you are truly a ‘Princesses on the Pea’ type, there is a Valium with your name on upon request. After Fraxel® re:store, he recommends applying a soothing coat of SkinCeuticals® Epidermal Repair Cream to help speed up flaking and soothe the tight n’ dry sensations.

Enter the next generation that has fellow Fraxelistas all abuzz, called Fraxel® Re:pair. Now this is hard core and not for the weak at heart. Remember carbon dioxide lasers in the 1990s that left everyone beet red and oozing into their chopped salads all over the upper east side? This is similar but different in that it is a kindler, gentler variation. The premise is that fractional ablative or CO2 lasers go deeper and do more work, and that this technology falls somewhere between the original fractionated systems that are more superficial, and the very deep lasers that basically no one wants anymore. The benefits are less downtime, redness, swelling, and a more significant improvement with the added plus of skin tightening. The results are about as close to a facelift as you can get without a scalpel. The downsides are that most girls need twilight anesthesia, and you may scare small children if you venture outside too soon. Recovery is about a week, depending on your complexion and how much you need done. You might want to send the guys in your life out of town when you do this. As you probably expected, sun exposure is a definite no-no for forever if you can, or for at least a few weeks or you will risk ruining your investment. The price tag is higher than the baby Fraxels; around $5,000 for the deeper version vs. $1,000-1,500 per session.

Therein lays the crux of the great laser debate that goes on between doctors and patients in every corner of the world. The more you do, the more it hurts, the more red you get, but the more dramatic results you get, and of course, the reverse is also true. Think of it as a trade off.


  1. MIC Says:

    Fraxel Repair is amazing. I have seen many patients a few weeks after and they look fantastic. Also consider the Mixto laser for skin rejuvenation and tightening.

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